Audiology-led model provides efficient and effective access to grommet surgery

ABSTRACT

Children with otitis media who are referred to paediatric otorhinolaryngology (ORL) departments often experience significant delays in treatment. Alternate models of care utilising audiologists with extended scopes of practice can potentially improve outcomes in services experiencing difficulties with high demand and insufficient ORL capacity. An Advanced Audiology Practitioner (AAP) service was implemented in Counties Manukau to combat known long wait times for children with otitis media. This study aimed to retrospectively evaluate the clinical and service outcomes of the 165 children referred to the AAP service during the initial 3 month period of operation. Engagement with the AAP service was high, with a 96% attendance rate at the first appointment. The proportion of children waiting longer than recommended (>120 days) for paediatric ORL appointments was reduced by 33%, and the average wait time for children seen in the AAP service was reduced from 196 to 14 days. The AAP model provided an efficient and effective clinical service, with 55% of children seen in a single visit and 91% of waitlisted children having middle ear effusion on myringotomy. In conclusion, the AAP model improves access to ORL treatment, particularly for children at risk for otitis media and associated hearing loss.

KEYWORDS:

• Extended scope
• ORL
• audiology
• model of care
• otitis media
• wait times
• clinical outcomes

Acknowledgements

The authors wish to acknowledge the AAP audiologists and ORL medical, nursing and administration teams for supporting the project. In particular, the authors thank Dr Lesley Salkeld for her provision of expert opinion in paediatric ORL service delivery, Annie Tyson (ORL Manager) for driving the project forward, and Jo Friend (Kaimaatai Tapuhi Haumanu (CNS) Planned Care) for advising regarding the kaimanaaki service.

Disclosure statement

No potential conflict of interest was reported by the author(s).